| NPI | 1841342300 |
|---|---|
| Other Name | BLUE MESA DENTAL OF AURORA |
| Entity Type | Organization |
| Authorized Contact | NORMA BERENICE GRIJALUA Office Manager 303-337-0789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 6619) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 8934) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |